Evidence map›Paper›PMID 41612286›Full record

Trial reportBMC health services research2026

A workforce enhancement model for Australian remote community Primary Health Care services: implementation of a stepped-wedge cluster randomised trial (SW-CRT).

Amanda Jane Leach, Amelia McCullough, Emily Websdale, Jiunn-Yih Su, Victor M Oguoma, Peter Stanley Morris, Sean Taylor, Sandra Nelson, Kelvin Kong, John Paterson and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03916029 (The Hearing for Learning Initiative - a Service-enhancement Model of Ear Health Facilitators to Address the Crisis in Ear and Hearing Health of Aboriginal Children in the Northern Territory), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03916029 nacompletednot on this map

The Hearing for Learning Initiative - a Service-enhancement Model of Ear Health Facilitators to Address the Crisis in Ear and Hearing Health of Aboriginal Children in the Northern Territory: a Stepped-wedge Cluster Randomised Trial

TypeinterventionalSponsorMenzies School of Health ResearchRan2019 to 2024Enrolled18ConditionsOtitis Media, Conductive Hearing LossArmsfacilitator
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Amanda Jane LeachMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia. amanda.leach@menzies.edu.au.
Amelia McCulloughMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia.
Emily WebsdaleMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia.
Jiunn-Yih SuMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia.
Victor M OguomaMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia.
Peter Stanley MorrisMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia.
Sean TaylorMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia.
Sandra NelsonDepartment of Health, Northern Territory Government, PO Box 40596, Manunda Place, 38 Cavenagh Street, Darwin, NT, 0800, Australia.
Kelvin KongJohn Hunter Children's Hospital, Hunter ENT Konara Suite 1, Level 3, 15 Lambton Road, Broadmeadow New, Hunter, New South Wales, 2292, Australia.
John PatersonAboriginal Medical Services Alliance of the Northern Territory, Moonta House, 43 Mitchell Street, Darwin, NT, 0800, Australia.
Jody DixonDepartment of Education, Northern Territory Government, Mitchell Centre, GPO Box 4821, Level 11, 55-59 Mitchell Street, Darwin, 0801, NT, Australia.
Alan CassMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFirst Nations people in Australia continue to experience a high level of socio-economic disadvantage, driven by the ongoing injustices of colonisation. In remote communities in the Northern Territory (NT) First Nations children experience early onset and persistence of middle ear infections (otitis media), preventable conductive hearing loss and developmental delay, which contribute to a trajectory of further disadvantage, particularly in education and employment. Health services are not resourced to deliver adequate care for these children. This trial of First Nations workforce enhancement is the first to address these issues.

methodsThis open cohort stepped-wedge cluster randomised trial of on-country training and new job creation was implemented in 2 pilot and 18 randomised remote communities. Governance of all aspects was co-designed, and First Nations led. Qualified trainers delivered three Certificate II units in Aboriginal Primary Health Care (2 weeks), and competency training in ear and hearing health, otoscopy, tympanometry, and hearScreen® (4 weeks). Community residents were eligible for training if they met criteria for NT Government employment. Here we report baseline characteristics and intervention implementation outcomes.

resultsOn-country training commenced in April 2020 and completed in November 2023. A new job description was approved for Ear Health Facilitators. Two randomised communities declined participation. The COVID-19 pandemic caused direct and long-term disruptions. From 167 expressions of interest, 53 of 89 (60%) enrolled participants completed all training. Lack of services interrupted attendance, whereas Liaison Assistants, meals, and payment were enablers. English language and numeracy were barriers. Trainee self-evaluations showed substantial increases in confidence, knowledge, and skills. Trainers assessed performance against 38 competencies, identifying strengths and areas for training modification. Trainees requested more flexibility and catch-up opportunities, more time for two-way learning, and to practice ear assessments. Thirteen communities employed 15 Ear Health Facilitators.

conclusionsThis trial of a remote health workforce enhancement model demonstrated feasibility and preference for on-country work-readiness and technical training with harmonised job creation. This has the potential to improve effectiveness and sustainability of priority health services – in this case, ear and hearing health care. Infrastructure to support development of this workforce was a major barrier. Evaluation of workplace integration, sustainability, and impact on ear and hearing services will be reported separately. TRAIL REGISTRATION: This trial was registered on clinicaltrials.gov on 16 April 2019, ID NCT03916029.

Indexed as

Health Services, IndigenousPrimary Health CareRural Health ServicesFemaleHumansNorthern TerritoryAustraliaChildJob creationOtitis mediaPrimary health careRemoteRuralStepped-wedge cluster randomised trialTrainingWorkforce

Identifiers

PMID41612286
PMCPMC12924424

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.